TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 6r/ Date: lojnhrs,. ? 

Address: cgrs/ YupL ^f 

Remediation Contractor: fiv,yS,--f Trd.i^Jr.<y..,^ 7\^. . Year: .2-Dog 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video ofproperty (DVD) 

^ Executive Summary 

^ EPA-provided property sketch 

y Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

y Restoration Agreement 

a Settlement documents (i.e., for damage or to replace plants, etc.) 

y Confirmation data k •' • 

\Ff Photographs -

* / As-built sketch 

^ Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

[T Utility clearances 

Property information from Douglas Coimty Assessor's Office 

D 

D 

D 

TL, ^ 3/^0' } 

Signaturp^ ^Tlate 

40311361 

iiillllllllllllil 

Superfund 
• 

PROPERTY SUMMARY 

Date: 10/17/2008 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06/0004 | Month of: Sept/Oct 

Property Address: 2531 MAPLE ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A J Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl=288 PPM @ 8"; EA=224 PPM @ SCRAPE 

ATTACHMENTS 

1) Property sketch provided by EPA pursuant to contract specifications 

2) Signed Access Agreement including access agreements required for crossing other properties 

3) Pre-Excavation digital video clip/photographs 

4) Post-Excavation digital video clip/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Buih sketchi) Shall include fmal lead levels v) Legend 

ii) Contamination left behind areas vi) Contractor identification 

iii) Property address vii) Date 

iv) BVID number 

7) Other items to be included in the individual property file, if available, or obtained include: 

i) Pre-excavation agreement details (if any are made with the property owner) 

ii) Property Status Form signed by property owner 

iii) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iv) Signed form verifying satisfactory restoration 

v) Description of areas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
Rnd Record 

Backfill: 

Sample Area: 651 - 2531 MAPLE ST 

Owner: 

n Owner Occupied 

Owner Name: 

j DRUMMOND BRENDA K 

Owner Addressl: 

)C/0 OMAHA HABITAT FOR HUMANITY 

Owner AddressZ: 

|2204 AMES AVE 

City: State: Zip Code: 

|OMAHA |N E 168110 

Owner Phone: Alternate Phone: 

r I 

Qean Up Query Lead Remaining Query j

Resident: 

Resident Name: 

I 

Property Address: 

J2531 MAPLE ST 

Zip Code: 

68111 

Resident Phone 

 Property Damage Query Close 

Contract: 

Assessment: 

Qualifying Group 

|PRIORITY 

Assessment XRF Date: 

I 

Assessment Max XRF Value: 

I 578' 
^ERfii 

EPA Property Close Out 

Property #: ^ 5") Property Address: o?:531 ^ ^ P<-^^ fDate/Time: Owner'sName: B^e n Df>, 0.SLG|! ^ 

Quads Excavated: V O Contractor Group Prudent Technologies 

Excavation General Yes No 

L If necessary, were the correct quadrant(s) excavated and restored? • 

2. If necessary, were the correct areas of drip zone excavated and restored? y 

Grading Sod and Vegetation 

Yes No 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? y 

2. Has sod been laid in all areas that were excavated? y 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) y

4. Are sodded areas generally firm and evenly graded? y 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) y 

6. Was the property graded such that water will not pool on the property? y 

7. Was damage to landscaping or plant materials avoided? 

y 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gates open and close freely? (If applicable) y 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) y 

3. Was damage to gates or fences avoided? (If applicable) y 

4. Was damage to retaining walls avoided? (If applicable) 

y 

Foundation, Siding and Gutters Yes No 

1. Was damage to the sidmg or trim avoided? \ y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? y 

4. Was damage to wmdows or door screens avoided? y 

5. Was damage to downspouts or downspout extensions avoided? 

• 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

Removal and restoration activates complete including the 30-day sod warranty: 

EPA Representative ^oj^ySLy Date: 9/2^(0^ 
«ER^ 

Property Completion Agreement 

This agreement documents the completion of removal activities performed on the below listed property. 

The property owner's signature indicates that the property owner is satisfied with the restoration ofthe 

subject property, and that no items are in question, now, or at any time in the future, excluding any 

remaining warranty (30 days total) except those items listed below, if any. 

Property ID: Pyf^^^ Q H^l^.E . 

Property Address y ^S ^^ \ nr^nn[P . S4- Owner: ^r^^^ Q Q^ s l^jg . 

Phone: LPoi^^ SU? - QOTJT; ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

r Required corrections to complete the property: 

L J I agree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 

yRy^/^^ /I<y.A J ^In/af? 

Owner's Signature Date 
... 

Piudtnt T »cfanclo9»E, Inc. (Pmd«aQ is undti contract wi& tht U. S. Enviionmtntal Piottction Agotcy (EPA) to cltm up Itad­ contmiinrttd wilE it a numbti of pioptititE locattd in Omaha, K tbiadca, includizQ tht pioptity locattd at . Tht EPA itqutEts your ptmisaon to allcnr Ftudtnt to ptifona a soil cltanup at His 

pioptity to itmovt ItadrcmtamiTialtd soil. By cignng tis fcim, tht pioptity ovnti gnnti ptmuEaon to Piudtnt to ptifona 

activititEitlattdtotht cltsn^includii^niil aaplin^ itmoval of Itad-contirniirHttd soil, anditstoiation of tht itftitnctdpioptity. 

If you hart any qutsdons about tht soil cltanq> planntd foi yots pioptity, pitast contact Piudtnt's AdmimaialiTt Cltilc foi tht 

OmahaLtadSitt cltamgi. Ms. Shannon Holt-at (402)304-1004. Gtntial qutstions aboutftit OmahaLtadSitt cltaiup canbt 

diitcttd to tbt£PAPublicInfomiationCtnttnat(;40:^ 731-3043 (^oulh Omafaa offict) oi (402) 991-9383 (Noith Oraaha offict). 

Piopti^ Acctss Gianttd By. (Pitast Pnntll amt) 

PioptityOwntiSignatuit: C^jfUwYl ^ QSHQA J __h/Ai/i> P 

(Sgnatutt) 7 (pju) 

PROPERTY MFORMATION 

(Tt to cvmflttti. ty iwaifl>taai/trpr»perty ownar - plwaBf rJMt) 

RESIDEMTHAME: V) Tgj u g \ (DAe^yT \owneA Rerrter 

RESIDENT ADDRESS: 

IF RENTAL. PROPERTY OWNED BY: 

OWNER'S MAILMG ADDRESS: 

Q 5?a \ tV>0>plP 5^V C)\l^7^^ k3^ d^ll I 

OWMER-STELEPHONE NUMBER - HOME: J )_ WORK: 

AGE OF HOME?: YEARS. HOW LONG HAVE YOU LIVED HERE? \ 7 YEARS. 

<^cUv>^ 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WOH SDING SINCE 13787 Y W —NO . 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: ^ NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

-M- NUMBER OF CHILOREN UNDER 7 YEARS OLO WHO PLAY M THE YARD FOR 5 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (IE. DOGS. ENTRY GATES. ETC.) 

AUTHORITY FORENVIRONMENTAL RESPONSE ACTIONSi Tht activititstobtimpltrntiitdbyEPAundtithis agrttmtnt 

jftBinsuaitf to Stction 104 of CERCLA, 42 US£;. 9604. EPA's li ^ of acctss to tht pioptity ispiovidtdforinStctionl04(t) of 

CEKCLA,42 U £. C 9£03(t), which piovidts tmiy foi "dtttTiwiningtht nttd foi it^onst, oi chooang oi taldng arf itqionst actic action undti this titlt, oi othtnrist tnfoicixQtht piorniions of tht titlt." 

8080 Ward Parkw^. Sulfa 405 ZSOS N. 24** Street Suite 308 4242 Medical Dilve. Suite 4250 

Kansas CHy. MO 64114 Omatia. Nebraska68110 San Antonio. TX 78229 

Phon«: (816) 368-3703 Phone: <402) 504-1 «}4 Dhnna- ^210^ S22-9SS9 C/-VW- M-«i*V «fM» OTA T Fax: (402)504-1005 FfflC ^^ioj 573^5577 
651 

AS - BUDLT DRAWING ^ 

OMAHA LEAD SUPERFUND SITE 

OLS#: 651 

Date Excavated: 8/14/2008 

Date USEPA Signed-OfT: 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: Sit • Good e Sketch Address: 2531^MAPLE ST Q Poor 

Phone: H Q Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm: _ 

Samples Collected 

Sverdrup 

RYASCPXA-651 YA 102 6 ppm n Date: . 

RYBSCPXA-651 YB , ppm a D Time: . 

RYCSCPXA-651 

RYDSCPXA-651 

YC 

YD 

108 

578 

.ppm 

ppm s Si 

n Samples Analyzed 

RDZSCPXA-651 DZ 93 ppm El a XRFUnf t: Book; 

RGZSCPXA-651 GZ .ppm a a Date:. 4/28/1999 

RPZSCPXA-651 PZ . ppm D a Time:. 10:21 

Staff: Numberof Samples: 

Legend: YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden. PZ = Play 

CONTRACT #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
ECHNOLOGIES, INC. 

Property Status Form 

Address: ^^3 ^ VAa^\ ^ ^y. Date: J^ ^ ^ ^ ^,< ^ 

Phone: BVID: ^-0 1 (^.-5 \ ' ^o a - ^t>U2^ 

Plants & Permanent Landscaping 

Item# 

On Map Description and Location 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes — No 

Item# Description & Location 

On Map 

Property Owner Prudent E: 

Signature:^)(\S^'Vfjl^ 0^» ^ Signaturi 

8080 Ward Parkway, Suite 405 2505 N. 24'-'' Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
^ 

651 

Exterio North Arrow Omaha r Paint Lead Site Owner Name: 

Site • Good Sketch Address: 2531 MAPLE ST A • Poor Phone: H: W; 

Q Not paint 

Sannple Number Lead Sample Samples Collected LAB Concentration Collected Firm; Sverdrup 

RYASCPXA-651 YA 102.6 

ppm 0 D Date: 

RYBSCPXA-651 YB 

ppm a D Time: 

RYCSCPXA-651 YC 108 ppm 0 0 

Samples Analyzed 

RYDSCPXA-651 YD 578 ppm D 

RDZSCPXA-651 DZ 93 ppm a 

D XRF Unit: Bock: 

RGZSCPXA-651 GZ 

ppm a • Date: 4/28/1999 

RPZSCPXA-651 PZ 

ppm •

Time: 10:21 

Staff: Number of Samples = 4 1 

Legend: YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

.! M/^PLS ^ - .. 

• ; • 

# 

Rev 4 AL^LEY 046141.0123 
651 

Omah Exterior Paint North Arrow a Lead Site Owner Name: []] Good 

Address: 2531 MAPLE ST Site Sketch A

• Poor 

Phone: H: W: Q Not paint 

Sample Number 

RYASCPXA-651 YA 

Lead 

Concentration 

102.6 ppm 

Sample 

Collected 

0 

LAB 

a 

Firm:

Date: 

Samples Collected 

 Sverdrup 

RYBSCPXA-651 YB ppm a a Time: 

RYCSCPXA-651

RYDSCPXA-651

 YC 

 YD 

108

578

 ppm 

 ppm 

0 

0 

0 

n Samples Analyzed 

RDZSCPXA-651

RGZSCPXA-651

 DZ 

 GZ 

93 ppm 

ppm 

0 

D 

n

• 

XRF Unit: 

Date 4/28/1999 

Book: 

RPZSCPXA-651 PZ ppm 

a Time 

Staff: 

10:21 

Number of Samples = 4

Legend: YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

H^PLE 6X .. 

Rev 4 Ai^LE-Y 046141.0123 
651 

Omah Exterior Paint North Arrow a Lead Site Owner Name: • Good Site Sketch / \ Address: 2531 MAPLE ST • Poor 

Phone: H: W: 

Q Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: Sverdrup 

RYASCPXA-651 YA 102.6 ppm 

0 n Date: 

RYBSCPXA-651 YB ppm a n 

Time: 

RYCSCPXA-651 YC 108 ppm 0 0 

Samples Analyzed 

RYDSCPXA-651 YD 578 ppm 0 n 

RDZSCPXA-651 DZ 93 ppm 0 n 

XRF Unit: Book; 

RGZSCPXA-651 GZ ppm n a

Date: 4/28/1999 

RPZSCPXA-651 PZ ppm n 

Time: 10:21 

Staff: Number of Samples = 4 1 

Legend: YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

I M^Pl-E 6T. 

' y 

[Rev 4 AL-UEY 046141.0123 
R20031000000001.jpg (JPEG Image, 640x480 pixels) http://douglasne.mappmg-online.com/assessdoc/Photos/05/R200310... 

^ 

PRIL 2004 - DOUGLAS COUNTY ASSESSOR 

5 5 3 1 MAPLP ^ J 

lofl 7/2/2008 9:26 AM 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas%20County-Oinah... 6/12/2008 
Print Preview http://www.dogis.org/dogis_alias/dogis/printPreview.aspx7PrintOpt.. 

Douglas County-Omaha, NE 

Panel 

ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

2 

Owner 

City 

Owner 

State 

Owner 

Zip 

2003100000 Sec-Twn-Rng 

DRUI^MOND Addition BRENDA K 

2531 MAPLE Block ST 

OMAHA Lot 

68111 Legall 

C/0 OMAHA 

HABITAT Legal 2 FOR 

HUMANIPl' 

2204 AMES Legal 3 AVE 

OMAHA Legal 4 

NE Treasurer 

Website Link 

68110 Assessor 

Website Unk 

09-15-13 

PATRICKS ^^S-ADD 

3 

8 

50X120 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp?parc=2003100000 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp7accountno-R2003100000 

Disclaimer Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 37 feet appraisal, survey, or for zoning verification. 

lof l 6/6/2008 1:03 PM 
iiiiiiiiaii 

&fe'.'***!E 


iT^ . 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2095882. 

Original Call Date: 7/31/08 Time: 11:29 am Op: RAMITA18967 


Work to Begin Date: 8/04/08 Time: 12:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2531 Street: MAPLE ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-NE-SE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation work 


Location of Work: LOCATE ENTIRE PROPERTY LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)733-1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: RAMITA Phone: (402)733-1455 


Alt. Contact: Phone: (402)733-1188 


Work Being Done For: EPA 


Depth of Excavation: 6ft Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS. INC HEIDI Ait: 4029340469 


Emerg: 4029329757 


Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Alt: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/31 /2008 
file:///C:/Users/lord''/aits%20my%20shepherd/Desktop/STREETS/2.. y ^ . 

Create Another Ticket Back to Irth Intemet Send Email 

YOUR TICKET NUMBER IS i 2077051. 

Original Call Date: 7/08/08 Time: 9:52 pm Op: RAMITA18967 


Work to Begin Date: 7/11/08 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2531 Street: MAPLE ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-NE-SE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remidation 


Location of Work: ENTIRE PROPERTY LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)504-1005 


: UNSURE CORNER 


Company : 

Contact Name: 

Alt. Contact: 

PRUDENT TECHNOLOGIES 

RAMITA Phone:

Phone:

 (402)504-1004 

 (402)452-9806 

Work Being Done For: EPA 

Depth of Excavation: 6ft Corner Lot: 

Involves Tunneling or Horizontal Boring : 

CXCATV MUDOl OMAHACOF 0PPDGPR5 

N Front: Y

N Explosives: N 

QLNNEIC 

 Rear; 

Utility Service Area Contact Phone Number Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

METROPOLITAN UTILITIES MUDOl EDWINA Alt: DISTRICT 

Emerg: 4025047946 

Day: 4024447197 


CITY OF OMAHA- OMAHACOF R ON Alt: 4024445161 TRAFFICSEWER 

Emerg: 4024445160 


Day: 4067289343 


OMAHA PUBLIC POWER 0PPDGPR5 N A Alt: 8887289343 DISTRICT 

Emerg: 4067289343 


Day: 4067289343 QLNNE 1C QWEST LOCAL NETWORK NA 

1 of 2 7/9/2008 1:17 PM 
file:///C:/Users/lord''/^s%20my%20shepherd/Desktop/STREETS/2 " / ^ . 

Alt: 

Emerg: 8887289343 

2 of 2 7/9/2008 1:17 PM